This invention relates to a pessary for vaginal support against prolapse in situations where the deteriorating tonicity of the pelvic ligaments permits the descensus of the female organs. There are various degrees of descensus, a prolapse that permits severe intussusception being referred to as fourth degree and which can result in protusion of the cervix at the vulva. Although the pessary hereinafter disclosed is advantageously useable in lesser situations, it is particularly useful with persons who are not candidates for pelvic surgery, due to physical fitness and/or old age. In any case, the advent of such a problem within an individual is physiological and social as well as medical, and in those cases where surgery is not feasible, treatment with a pessary is often prescribed. It is the disorder of the internal female organs which is to be corrected, for example the displacement of the bladder that causes urinary incontenance and which is relieved by support with this pessary to effect a vesicular angle for proper functioning of the urethra and retention of urine.
Heretofore, pessaries for the purposes referred to herein have been difficult to insert and to remove, such devices being characterized by circular rings, elongated rings, inflated bladders, and cubes, cubes and/or solids wherein suction is afforded by the moist vaginal mucosa which invaginates into concavities are most annoying and even painful upon removal. It is a general object therefore to prevent annoyance and pain that would otherwise be caused by invaginate action which normally retains such devices in working position.
The vagina is that reproductive organ of the squamous mucus membrane canal that enters the pelvic cavity from the vulva, and into which the cervix of the uterus opens. The vagina is supported by and passes through the perineal sling, taking various positions in different individuals, but generally of tubular formation with the mucosa that invaginates and expansively folds together to form an elongated vault with the cervix normally protruding therein anteriorly at its innermost depth. The mucosa is readily expanded and will permit prolapse when the pelvic support weakens, and will permit the intrusion of cystourethroceles, rectoceles and the like. An object of this invention is to provide means which ensures invaginate retention of the pessary in use and which releases the suction thereof when the pessary is to be removed.
The perineal sling is that system of muscles which are normally toned to support the internal organs of the anatomy by means of an internal boarder or shoulder superior to the introitus and within the pelvic cavity and comprised of the following muscles with their facia and supporting structures; namely the pubococcygeus, levator ani, transverse perineal and bulbo-cavernosus muscles. It is this muscular boarder which forms the natural support upon which the device of the present invention rests. Accordingly, it is an object of this invention to provide a replaceable pessary that is releasably held in working position by the perineal sling.
An object of this invention is to improve pessarie of the type hereinabove referred to by including therein a valve means that releases the invaginate suction when removal is required. With the present invention, invaginate suction is normally maintained by said valve means during use, and by manipulation is released for facilitating removal without annoyance in breaking suction with the vaginal walls.
It is an object of this invention to provide a simple and sanitary unit of construction characterized by a single valve element that is adapted to be set in working position and that is shiftable to open suction concavities to atmosphere and to establish a pull stem for removal of the pessary. The valve means comprises a shiftable element in the form of an anchoring stem that has two positions, a set working position and a vent position engageable with the pessary body to withdraw the same from working position.